JHLT open · 2026
Cardiogenic shock in pregnancy: Prolonged axillary Impella 5.5 support during pregnancy and postpartum as bridge to heart transplantation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Laks Shahar, Pierce-Williams Rebecca, Connors Ngina, Brown Kelecia, Philips Jennifer, Holmes Diane, Canha Catarina, Cyrille-Superville Nicole, Kim Esther, Oye Monique
Аннотация
BACKGROUND: Cardiogenic shock during pregnancy carries substantial maternal and fetal morbidity and mortality, and guidance on temporary mechanical circulatory support (tMCS) in this setting remains limited.
CASE SUMMARY: A 36-year-old woman at 21 weeks' gestation presented with severe dilated cardiomyopathy (ejection fraction 20%, LVIDd 8.0 cm), cardiogenic shock (cardiac index 1.7 L/min/m²), and recurrent ventricular arrhythmias. She declined termination of pregnancy. An axillary Impella 5.5 was placed for hemodynamic stabilization with rapid improvement in cardiac output and filling pressures. Progressive ventricular arrhythmias at 23 weeks and 3 days necessitated urgent cesarean delivery; the neonate did not survive. The patient was supported with the Impella 5.5 for 66 days and underwent successful orthotopic heart transplantation.
DISCUSSION: To our knowledge, this is one of the longest reported durations of Impella 5.5 support initiated during pregnancy and continued into the postpartum period. This case highlights important considerations that may inform individualized multidisciplinary decision-making on temporary mechanical circulatory support selection in pregnancy-associated cardiogenic shock.
CASE SUMMARY: A 36-year-old woman at 21 weeks' gestation presented with severe dilated cardiomyopathy (ejection fraction 20%, LVIDd 8.0 cm), cardiogenic shock (cardiac index 1.7 L/min/m²), and recurrent ventricular arrhythmias. She declined termination of pregnancy. An axillary Impella 5.5 was placed for hemodynamic stabilization with rapid improvement in cardiac output and filling pressures. Progressive ventricular arrhythmias at 23 weeks and 3 days necessitated urgent cesarean delivery; the neonate did not survive. The patient was supported with the Impella 5.5 for 66 days and underwent successful orthotopic heart transplantation.
DISCUSSION: To our knowledge, this is one of the longest reported durations of Impella 5.5 support initiated during pregnancy and continued into the postpartum period. This case highlights important considerations that may inform individualized multidisciplinary decision-making on temporary mechanical circulatory support selection in pregnancy-associated cardiogenic shock.